The Feasibility and Acceptability of Delivering Brief Telehealth Behavioral Parent Training in Pediatric Primary Care

Behavioral parent trainings (BPTs) are highly efficacious manualized treatments for young children with disruptive behaviors. However, access and engagement can be challenging for most families that would benefit from treatment, thereby limiting the impact BPTs have on population health. Brief telehealth versions of traditional BPTs present a promising but understudied alternative to traditional in-person interventions and may ease the burden of participation for families. This study reports on a mixed-methods feasibility trial of a brief telehealth BPT delivered within a pediatric primary care practice. Twenty-seven families with children between ages 3-8 enrolled in the 4-session telehealth intervention. Caregivers and clinicians provided quantitative and qualitative data describing the feasibility and acceptability of the program. Data across informants suggested that the brief telehealth program was feasible to implement and acceptable to stakeholders, with a few important caveats. For clinicians, logistical support was key to engagement. Caregivers identified both facilitators of and barriers to engagement unique to the brief telehealth model. Caregivers and clinicians reported that positive parenting strategies were easier to teach and learn compared to disciplinary strategies, particularly time-out. We also found that despite improved flexibility of telehealth, attrition rates were still high and similar to rates observed in traditional delivery models. Brief telehealth programs hold the potential to expand the reach of evidence-based parenting interventions. However, these programs do not fully address barriers to care, and future interventions should be designed with the strengths and limitations of telehealth in mind. This study is among the first to examine the feasibility of brief telehealth parent training delivered within pediatric primary care.Using a mixed methods design, we found our 4-session telehealth program was highly acceptable to caregivers and clinicians.Caregivers easily learned positive parenting skills but found disciplinary skills more challenging to learn in the brief telehealth model.Delivering in primary care was feasible, but qualitative data revealed barriers specific to the setting and telehealth delivery.